Editing CUA: Small Renal Masses (2015) (section)

===== Background =====

* '''Definition of small renal mass (SRM):'''

#* '''Enhancing tumours'''
#* '''<4 cm in diameter'''
#* '''with image characteristics consistent with stage T1aN0M0 renal cell carcinoma'''

* Most SRMs are RCCs, ≈20-25% of SRMs are benign
* Even if SRMs are malignant, most of them grow slowly
* '''Small RCCs may be associated with metastatic disease at diagnosis in up to 8% of cases, so initial staging of all SRM patients is essential'''

#* '''Recall 2014 CUA Surgical Management of Renal Cell Carcinoma Consensus Statementrecommended investigations'''
#** '''History and physical'''
#** '''Labs: CBC, Cr, LFTs, calcium'''
#** '''Imaging: cross-sectional of primary tumour, CXR/CT'''

* Based on current data, initial active surveillance (AS) with delayed treatment for local progression appears to be a relatively safe initial management strategy